Cascadia Behavioral Healthcare’s Peer Wellness Program

Infusing the Eight Dimensions of Wellness into Peer Specialist Training; Creating a New Generation of Peers

From SAMHSA’s Program to Achieve Wellness

The promotion of the Eight Dimensions of Wellness by the Substance Abuse and Mental Health Services Administration (SAMHSA) sheds light on the holistic nature of recovery. Being well is not just about a mental state, or even a physical state. Instead, wellness includes various dimensions like our sources of social support, enjoying our work, and feeling comfortable in our surroundings, among other areas. At Cascadia Behavioral Healthcare, this work of supporting the Eight Dimensions of Wellness for individuals with mental and/or substance use disorders is a priority, and an ongoing effort of the Oregon nonprofit. In fact, Cascadia is one of the largest nonprofit safety net behavioral healthcare providers in Oregon focusing on mental health, addiction, and integrated health services. Their focus on wellness allows them to serve people in local communities in innovative and effective ways.

Cascadia was moved to action by the October 2006 National Association of State Mental Health Program Directors (NASMHPD) technical report on morbidity and mortality. The 2008 Oregon Department of Human Services Addiction and Mental Health Division report, Measuring Premature Mortality Among Oregonians, also influenced Cascadia. The report indicated that the average age of death for people with co-occurring mental health and substance use was roughly 45 years old. There were decades of life lost compared to those without co-occurring disorders. Upon learning about the rates of chronic disease and premature death experienced by Oregonians with mental and/or substance use disorders, Cascadia developed a peer wellness program. Cascadia’s Peer Wellness Program trains people, “who have lived through mental health challenges and learned to cultivate their own wellness.” These individuals build the skills and tools needed to support their peers in making healthy lifestyle choices. Peer Wellness Specialists help clients by addressing lifestyle and risk factors before they reach a crisis stage. This interrupts the cycle of disease and improves quality of life for the people they work with.

Cascadia’s Peer Wellness Program enhances a basic certified peer specialist training with chronic disease self-management and self-care tools. It also offers skills for supporting peers who may be managing a number of complex health needs. Wellness is integrated with a strong focus on prevention and health promotion, all through a person-centered lens. The enhanced training dives into topics like health literacy and the social determinants of health. Generating true community transformation, graduates who join the Cascadia Peer Wellness Specialist Workforce commit to a minimum of 2-3 hours per week, up to a maximum of 40 hours per week, to support peers in their recovery.

This training is innovative and unique: 39 states across the U.S. offer peer specialist training or certification programs. Of those states, nine (9) incorporated broad concepts of wellness and only six (6) incorporate self-care.* In Oregon, Cascadia is one of those six, offering a peer wellness specialist class that is approved by the Oregon Health Authority. Oregon offers state certification to both peer support specialists and peer wellness specialists. Peer wellness specialists differ from peer support specialists: their advanced training prepares them to be effective members of treatment teams in person-centered integrated health homes. Further supporting both occupational and intellectual wellness, those who complete the peer wellness training can also receive eight hours of college credit from Portland State University. Both the state approval and university linkage showcase this peer specialist training as inventive. Cascadia leverages partnerships and delivers a meaningful training that can help peers support wellness for themselves and those they work with.


Braunwynn Franklin, Meghan Caughey and Ananda

In addition, a legislative mandate in the state of Oregon requires that peer wellness specialists are part of coordinated care organizations, in person-centered health homes. This legislation, Oregon House Bill 3650 passed in June 2011, emphasizes the importance of the training offered by Cascadia and the integration of wellness in recovery.

Cascadia has trained approximately 200 people in the state of Oregon as peer specialists. Of those specialists, 25 work for Cascadia and help to serve the estimated 14,000 people who receive services at Cascadia each year.

We would like to thank Meghan Caughey at Cascadia Behavioral Healthcare for taking time to talk with the Program to Achieve Wellness about their programs, achievements, and challenges. For more information about their work, please visit



*Kaufman, L., Brooks, W., Bellinger, J., Steinley-Bumgarner, M., & Stevens-Manser, S. (2014). Peer specialist training and certification programs: A national overview. Texas Institute for Excellence in Mental Health, School of Social Work, University of Texas at Austin. Retrieved from